Abayneh Mengistu, Worku Teshale
School of Medical Laboratory Sciences, Mizan-Tepi University, Mizan-Aman - Ethiopia.
Drug Target Insights. 2020 Oct 5;14:16-25. doi: 10.33393/dti.2020.2170. eCollection 2020.
Multidrug-resistant (MDR) extended-spectrum beta-lactamase (ESBL)-producing bacterial isolates have emerged as a global threat to human health. Little is known about the overall prevalence of multidrug resistance profile and ESBL-producing gram-negative bacilli (GNB) in Ethiopia. Therefore, this meta-analysis was performed to produce proportional estimates of multidrug resistance and ESBL-producing GNB in Ethiopia. A web-based search was conducted in PubMed, Google Scholar, Research Gate, Scopus and other databases. Articles published till 2019 on the prevalence and antimicrobial resistance profiles of ESBL-producing GNB in Ethiopia were included in the study. Relevant data were extracted and statistical analysis was performed using comprehensive meta-analysis version 3.3.0 software. Publication bias was analyzed and presented with funnel plots. In this meta-analysis, the overall proportional estimate of ESBL-producing GNB was 48.9% (95% confidence interval [CI]: 0.402, 0.577). The pooled proportional estimates of ESBL-producing and other GNB were 61.8%, 41.2% and 42.9%, respectively. Regarding antimicrobial resistance profiles against selected drugs, the pooled proportional estimates of resistance against amoxicillin-clavulanic acid, trimethoprim-sulfamethoxazole, cefotaxime, ceftazidime, tetracycline, gentamicin and ciprofloxacin was 79.0%, 78.4%, 78.0%, 72.4%, 72.7%, 58.9% and 43.8%, respectively. The pooled proportional estimates of MDR isolates were found to be 82.7% (95% CI: 0.726, 0.896), which are relatively high as compared to other countries. This highlights a need for active surveillance systems which can help understand the actual epidemiology of ESBL, aid in formulating national guidelines for proper screening of ESBL and support developing standardized approaches for managing patients colonized with ESBL.
产超广谱β-内酰胺酶(ESBL)的多重耐药(MDR)细菌分离株已成为对人类健康的全球威胁。关于埃塞俄比亚多重耐药谱和产ESBL革兰氏阴性杆菌(GNB)的总体流行情况,人们了解甚少。因此,进行了这项荟萃分析,以得出埃塞俄比亚产ESBL GNB和多重耐药情况的比例估计值。在PubMed、谷歌学术、Research Gate、Scopus和其他数据库中进行了基于网络的搜索。该研究纳入了截至2019年发表的关于埃塞俄比亚产ESBL GNB的患病率和抗菌药物耐药谱的文章。提取了相关数据,并使用综合荟萃分析3.3.0版软件进行了统计分析。分析了发表偏倚并用漏斗图表示。在这项荟萃分析中,产ESBL GNB的总体比例估计值为48.9%(95%置信区间[CI]:0.402,0.577)。产ESBL GNB和其他GNB的合并比例估计值分别为61.8%、41.2%和42.9%。关于对选定药物的抗菌药物耐药谱,对阿莫西林-克拉维酸、甲氧苄啶-磺胺甲恶唑、头孢噻肟、头孢他啶、四环素、庆大霉素和环丙沙星的耐药合并比例估计值分别为79.0%、78.4%、78.0%、72.4%、72.7%、58.9%和43.8%。发现多重耐药分离株的合并比例估计值为82.7%(95% CI:0.726,0.896),与其他国家相比相对较高。这凸显了需要建立主动监测系统,以帮助了解ESBL的实际流行病学情况,协助制定适当筛查ESBL的国家指南,并支持制定管理携带ESBL患者的标准化方法。
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